Can Acupuncture or Moxibustion (Moxa) Help with Turning a Breech Baby?

This article was co-authored by Sarah Tewhey, L.Ac., acupuncturist, herbalist and doula

Breech (feet first) position in the latter part of the third trimester of pregnancy is uncommon, but can prevent the possibility of a vaginal birth. In the United States, standard of care in breech term pregnancy is planned cesarean section, with over 90% of breech babies at term in 2019 being born via cesarean birth (1). While only 3-4% of pregnancies are breech at term (2), this small percentage represents thousands of cesarean births each year. Planned cesarean birth due to malposition carries risk, can significantly affect the pregnant person if they had hopes for a vaginal birth, impacts maternal outcomes including postpartum recovery and adds costs to the healthcare system as a whole. It is to the benefit of both pregnant people and hospitals to have a range of corrective options to help babies turn cephalic (head down) prior to planning a cesarean birth.

Why Do We Need to Explore Other Ways of Correcting Breech Presentation?

The most common intervention for breech presentation is External Cephalic Version (ECV). During an ECV, a trained healthcare provider uses their hands on the outside of the abdomen to manually turn the baby into a cephalic position. ECV is typically attempted at 36-37 weeks gestation and is 50%-60% effective (1). However, ECV is not routinely offered to all pregnant people whose babies are breech, may not be accessible in some locations where a trained provider is not available and carries some risk of complications. In addition, ECV can be physically painful and create emotional stress. For these reasons ECV is not an intervention that all pregnant people are offered or choose to attempt.

Moxibustion and acupuncture provide potential as an additional intervention for correcting a breech presentation that is cost effective and low risk (3). For parents, learning that their baby is breech can create a range of complex emotions. Parents may face both internal and external pressures when making decisions around potential interventions (6). Choice and shared decision making are important to pregnant people. Providing an option for moxibustion and acupuncture may be a welcome addition to the conversation between parents and their prenatal providers when making decisions around interventions for breech. In clinical practice it is increasingly common for midwives and physicians to refer pregnant people to acupuncturists prior to trying other interventions such as an ECV.

How Might Acupuncture and/or Moxibustion (Moxa) be Used?

Acupuncture and moxibustion have been used for centuries in East Asian Medicine for a wide array of concerns. Acupuncture is the insertion of fine needles into specific points on the body for the purpose of influencing a myriad of physical and mental/emotional conditions. Moxibustion is the application of heat to acupuncture points by burning preparations of the herb Ai Ye or Artemisia argyi near the skin. For the purpose of correcting fetal position, moxa is generally used in the form of a rolled cigar-like stick to indirectly warm a point located on the outer edge of the 5th toe known as Zhi Yin or Urinary Bladder 67. The moxa stick is moved in a slow pecking motion to gently warm the point once or twice daily for 15-30 minutes each session.

While more research into the most effective dosage and timing to correct malpresentation is needed, there are current practices within the acupuncture community which are regarded as the standard of care. In a 2013 Delphi survey (5) of 12 acupuncturists selected due to their expertise in providing care during pregnancy, 80% of respondents indicated that treatment should commence between 34-35 weeks. 90% agreed that home use of moxibustion with smokeless moxa sticks was the most appropriate method and 70% indicated treatment for a minimum of 10 days for at least 30 minutes a day to be optimal. All respondents agreed Urinary Bladder 67 is the preferred point for administering the moxibustion. 50% of respondents indicated that treatment with acupuncture was also an important part of care in correcting malpresentation. All respondents felt that moxibustion could safely be administered at home after instructions on use and safety were provided by an acupuncturist.

After receiving education on use, pregnant people can then self-administer the moxibustion outside a clinical setting. Moxibustion as an optional intervention can provide pregnant people with increased choice and assist them in feeling more in control of an unexpected and often stressful situation. Daily treatment at home may also create feelings of relaxation and increased connection with their partner, who can be involved with administering the treatment (6). All of these factors can positively impact a pregnant person’s perception of their pregnancy and birth. After being seen for acupuncture and performing home treatment, babies may be cephalic at their next primary care prenatal visit. If the treatment is ineffective, ECV is still an option at 36-37 weeks gestation.

In addition to acupuncture and moxibustion, some pregnant people may also receive guidance on positional exercises, chiropractic and/or pelvic physical therapy to help encourage their baby to turn. All of these methods can work in tandem alongside acupuncture and moxibustion and usual care.

What does the Research Show?

This plain-language summary will primarily focus on the results of a type of study called a Systematic Review (SR). SR’s combine the results of several individual studies that are somewhat similar. For this reason, SR’s are more important and impactful than looking at one or two studies alone.

A 2012 Cochrane Systematic Review by Coyle et al. (7) looked at 8 trials (1346 participants) that assessed the use of moxibustion, acupuncture, postural techniques and usual care for breech presentation. Of those 8 trials, 3 studies (594 participants) compared moxibustion treatment alone to usual care and found no significant difference in the rate of cephalic babies at birth. However, a more recent 2021 Systematic Review by Liao et al. (8) looked at the same 3 studies plus an additional 10 trials (2063 participants) and found that those using moxibustion at UB 67 versus those receiving usual care did have an increased rate of cephalic presentation at birth.

These two SR’s (7,8) also analyzed trials using moxibustion combined with another type of treatment such as acupuncture or postural techniques. A few studies even looked at acupuncture alone (without moxibustion). Both SR’s found that acupuncture plus moxibustion resulted in a higher number of head-down babies at birth compared with usual care. Only the 2012 Cochrane Review looked at moxibustion used alongside postural techniques versus postural techniques alone. It found that across those 3 studies, there was an increase in the number of head-down babies at birth in those using moxibustion.

Finally, the 2021 Systematic review (8) looked at trials which compared acupuncture alone to a control group. Two studies (146 participants) found no difference in the number of head-down babies at birth. Because this finding is represented by only two studies and both were small, additional, larger studies are needed to have more certainty about the impact of acupuncture alone on babies’ position.

Does It Really Matter Which Acupuncture Point Gets Moxibustion?

Vas et al. (9) conducted a study in 2013 which tried to determine if the UB 67 acu-point (at the outer edge of the 5th toenail) is specifically helpful with turning breech babies. This trial was large and well-designed with three groups: those who had moxibustion at the usual point UB 67, those who had moxibustion at an “inactive” point on the inner edge of the 1st toenail and those who had usual care. The study found that moxibustion on UB 67 resulted in head-down babies in 58% of participants, while the other two groups had significantly fewer head-down babies (43% and 45%). Although additional studies are needed before making definitive conclusions, because this study was quite large (406 participants) and well designed it indicates that there may be something unique about the UB 67 acu-point that is helpful for fetal malpresentation.

Moxibustion Included in Clinical Guidelines

Moxibustion and acupuncture are included in the (UK) 2017 Royal College of Obstetricians and Gynecologists (RCOG) Green-top Guidelines for ECV and Reducing the Incidence of Term Breech Presentation (10). This document represents the first time that these methods of treatment have been included as a clinical guideline by a major professional organization within the field of Obstetrics. The guidelines cite both the 2012 Cochrane Review and the 2013 Vas et al. study and recommend that pregnant people may wish to consider the use of moxibustion at 33-35 weeks gestation. The recommendation also cites that acupuncture combined with moxibustion may further reduce the number of cesarean sections and emphasizes the importance of choosing a trained practitioner when seeking out this type of treatment.

Risk Factors and Contraindications

There are some instances where acupuncture and moxibustion may present increased risk or be contraindicated when assisting babies to turn. These are similar to contraindications for ECV and may include Olgiohydraminos (too little amniotic fluid); Polyhydramnios (too much amniotic fluid); a history of vaginal bleeding in pregnancy, known fetal abnormalities or growth issues, history of PROM or premature labor, gestational diabetes, hypertension; placenta previa; bicornuate uterus; twins or other non-singleton pregnancy and any concern in which ECV is contraindicated by the primary care provider. In these situations the decision on whether to use moxibustion should be made via collaboration and mutual agreement between the pregnant person, the acupuncturist and the primary prenatal care provider.

Finding a Trained Practitioner

Most acupuncturists receive some limited training in perinatal care, however working in this specialty safely and effectively requires additional post-graduate education. When choosing an acupuncturist, ask questions about what education and experience they have in treating pregnant people. Local midwives, doulas, Labor and Delivery nurses and physicians will be familiar with acupuncturists who specialize in perinatal health and who are qualified to help. These types of providers can make referrals to well trained practitioners.

Additionally, in choosing an acupuncturist, make sure they are aware of the methods, safety concerns and contraindications to using moxibustion for breech. Practitioners should also provide thorough instructions and support to the pregnant person for home moxibustion use.

Mechanism of Action, Safety Information, Contraindications

Mechanism of Action

The mechanism by which moxibustion and acupuncture may act to correct fetal malposition is unknown at this time. It is understood that acupuncture affects a diverse array of biochemical processes within the body and also has direct effects on the central nervous system (16). However, how acupuncture point Urinary Bladder 67 can change fetal presentation has not been determined. According to the 2012 Cochrane Review, one theory is that it may stimulate the production of maternal hormones (placental estrogens and prostaglandin), and encourages the lining of the uterus to contract which in turn stimulates fetal activity. A 1998 study by Cardini (11) found a statistically significant increase in number of fetal movements per hour (as counted by the pregnant person) in patients undergoing moxibustion therapy. The number of movements per hour was still within normal range. Much more research into the mechanism of action of acupuncture and moxibustion that could affect this specific condition of pregnancy is needed. Understanding mechanisms may also assist with study design to help determine the best dosage and timing for treatment.

Safety

Combined, the 2012 Cochrane Review and the 2021 Liao et al Systematic Review pooled data on adverse events reported in 4 trials. No adverse events were reported in 3 trials, however in 1 trial (Cardini 2005) (12) participants undergoing moxibustion treatment reported unpleasant odor, nausea and abdominal pain. This trial seems to be an outlier in terms of poor compliance, high rate of participant dropout and adverse events.

Generally accepted best practice guidelines for using moxibustion include performing it in a well-ventilated room (or outdoors) and using “smokeless” moxa sticks which have been carbonized to produce far less smoke than pure moxibustion sticks. If these guidelines are not followed, there is the potential for irritation to the respiratory tract from the smoke. In addition, the person performing the moxibustion treatment must be attentive to avoid accidental moxa stick contact with the skin, which can result in blistering or burning. The pregnant person as well as any partners who may be performing the treatment at home should undergo detailed instruction and a demonstration of safely performing moxibustion and extinguishing the stick afterwards.

Acupuncture and moxibustion for breech presentation appears to be a safe and well tolerated option for pregnant people when they are treated and adequately instructed in appropriate usage by a trained provider.

Risk Factors and Contraindications

There are some instances where acupuncture and moxibustion are contraindicated or present increased risk when assisting babies to turn. These are similar to contraindications for ECV and may include Olgiohydraminos (too much amniotic fluid); Polyhydramnios (too little amniotic fluid); a history of vaginal bleeding in pregnancy, known fetal abnormalities or growth issues; history of PROM or premature labor; gestational diabetes, hypertension; placenta previa; bicornuate uterus; twins or other non-singleton pregnancy and any concern in which ECV is contraindicated by the primary care provider. Decisions about whether or not to attempt this type of treatment with the above mentioned conditions should be made between the pregnant person, the acupuncturist and the primary prenatal care provider.

Detailed Research Information: Systematic Reviews

Summary of Systematic Reviews:

In the last 10 years, two major Systematic Reviews have been conducted in order to pool the results of studies that looked at similar treatments.

These two systematic reviews also looked at studies comparing acupuncture plus moxibustion versus usual care. The 2012 Cochrane review (7) looked at 1 study with 226 participants and found an increased rate of head-down babies at birth as well as a reduced number of cesarean sections. The more recent 2021 review (8) looked at 2 studies (346 participants) and similarly found an increased rate of head-down babies at birth when acupuncture and moxibustion are combined for treatment.

Only the 2012 Cochrane review (7) compared moxibustion plus postural techniques versus postural techniques alone: 3 studies with 470 participants found an increase in the number of head-down babies at birth.

Discussion of 2012 Cochrane Systematic Review:

The 2012 Cochrane Review (7) included 8 trials and 1346 study participants. It was limited to studies available in English language publications.

This review found that acupuncture and moxibustion combined resulted in fewer non-cephalic babies at birth and fewer cesarean sections. Moxibustion combined with postural techniques also decreased the number of non-cephalic babies at birth when compared with postural techniques alone.

Moxibustion alone showed no significant difference in cephalic presentation rates when compared to no treatment at all. Moxibustion alone did reduce the need for oxytocin before and during labor. However, the three studies that contributed data to this outcome deserve a closer look:

The first study, Cardini 1998 (11) was the largest (n=260) and had a low risk of all types of bias. The trial included women in China at 33 weeks gestation who used moxibustion on UB 67 once or twice daily for 15 minutes on each toe. The comparison group received no intervention. This study, which was well-designed and clinically relevant resulted in a statistically significant reduction in non-cephalic presentation both at 35 weeks (p<.001, RR 1.58, 95% CI) and at birth (P=0.02, RR 1.21, 95% CI) for participants who received moxibustion. The researchers also found that during treatment, fetal activity was significantly increased in the moxibustion group, demonstrating a potential mechanism for how moxibustion might help to turn breech babies.

The second study, Cardini 2005 (12), involved 123 women in Italy at 32-33 weeks gestation. The trial was discontinued before it recruited enough participants to become adequately powered. 22% of participants were not compliant with the moxibustion treatment, and a number of participants reported adverse events including unpleasant odor from the moxibustion, nausea and abdominal pain. The authors concluded the study did not demonstrate whether or not moxibustion changed outcomes since it had to be discontinued after only 46% of the planned number of participants had been recruited. It’s interesting to note that the Cardini 1998 study (11) took place in China, in a cultural context where there was already a high degree of familiarity with and trust in moxibustion. Cardini 2005 (12) took place in Italy, and the authors noted that a large number of potential study participants declined to participate because of mistrust in the treatment and fear of harm to their baby.

The third study, Guittier 2009 (13) included 212 participants at 34-36 weeks gestation. It compared daily moxibustion at UB 67 for 10 minutes on each side for 2 weeks versus no treatment. No statistically significant difference was found in non-cephalic presentation with 18% of participants experiencing cephalic version in the moxibustion group versus 16% of those receiving usual care. In contrast to the high rate of study withdrawal and adverse effects reported by participants of the Cardini 2005 study in Italy, this study, conducted in Switzerland had excellent compliance and participants reported no adverse events. Participants overall felt the process of completing moxibustion was relaxing.

Discussion of 2021 Liao et al. Systematic Review:

The Liao et al. 2021 Systematic Review included 16 studies and a total of 2555 participants. Unlike the 2012 Cochrane review, it did not limit results to English language publications. An additional difference was the inclusion of two studies using acupuncture only (no moxibustion) compared with a control. These two inclusions are in contrast to the Cochrane Review which only included studies that used moxibustion, with or without other modalities.

In studies comparing moxibustion alone to control (13 studies, 2063 participants), researchers found a statistically significant effect for increased numbers of cephalic presentation babies at birth (RR = 1.39; 95% CI = 1.21–1.58). These studies included 2013 Vas et al (9), a large, well-designed study. A sensitivity analysis excluding two trials with a high risk of bias confirmed these findings.

In studies comparing moxibustion plus acupuncture to control (2 studies, 346 participants), researchers found a statistically significant effect for increased numbers of cephalic presentation babies at birth (RR = 1.53; 95% CI = 1.26–1.86). After sensitivity analysis, Yang 2010 (n=120) was excluded due to high risk of bias. The one remaining trial (Neri 2004, n=240) showed an increase in cephalic presentation at birth.

There was no significant difference in studies comparing acupuncture alone at UB 67 versus control (2 studies, 146 participants). One of these studies (Li 1996, n=111) was excluded due to high risk of bias and results remained the same.

Liao et al found that moxibustion with or without acupuncture has a positive effect overall on correcting breech presentation. The authors conducted a subgroup analysis and found moxibustion was particularly effective when used in Asian populations although it did show effectiveness though to a lesser degree in non-Asian populations. It is possible that in the existing trials examined there is better compliance and comfort with using moxibustion at home because it is already a widely known and accepted modality in Asian cultures. Though effectiveness and compliance in using moxibustion are certainly not limited to Asian populations (as demonstrated in Vas 2013 Spanish population, Guittier 2009 Swiss population and Do 2011 Australian population, among others), Cardini 2005 (12) showed major issues with willingness to complete or even begin treatment and poor compliance in an Italian population. Future research might investigate specific cultural factors which contribute to compliance and shape attitudes around moxibustion, including how (and by whom) the method is taught and explained to potential study participants.

Detailed Research Information: Notable Single RCT’s

2013 Vas et al Randomized Controlled Trial

Vas et al (2013) (13) is a single three arm trial which deserves mention for its unique, rigorous design. The study looked at both the effectiveness and safety of moxibustion treatment for breech, but also examined whether moxa applied specifically to UB 67 is more effective than moxa applied to an acu-point not typically indicated for correcting fetal malposition. In addition to these two moxibustion groups, researchers also included a control group that received usual care in the form of monitoring and instruction in “knee-chest postural management”. The dosage and duration of treatment used in the treatment groups was clinically realistic and relevant. The study was judged by Liao et al (8) to have a low risk of all types of bias.

In this trial, 406 women in Spain were randomized into 3 groups. The study group was large enough to determine statistical significance. The intervention groups either performed moxibustion at Urinary Bladder 67 or Spleen 1 (a point on the inner edge of the first toe) which is thought to be inert for purposes of altering a baby’s position. After receiving education from a midwife trained in moxibustion, the two groups performed moxibustion for 20 minutes daily at home for 2 weeks. The third group only had usual care and no moxibustion.

All participants were between 33-35 weeks. Such a narrow gestational window is helpful for comparison purposes when determining the best time to use moxibustion during pregnancy.

At term, vertex presentation was as follows: 58% for moxa to UB 67, 43% for moxa to SP 1 and 45% in the usual care group. In addition, maternal and fetal heart rate were monitored between all three groups and were not found to have significant differences. There were no major adverse events in either of the moxibustion groups and no differences in neonatal outcomes. This well-designed study is the first to compare outcomes between real and “sham” moxibustion for breech. The results showed the specific effect of UB 67 in turning breech babies compared with a sham group and a control group, which showed no significant difference in rate of vertex presentation.

Future Research Considerations

Future research on acupuncture and moxibustion for correction of breech presentation would benefit from more reporting on safety and adverse events in order to increase confidence in this technique by patients and prenatal providers. Additionally, comparative effectiveness research studies which aim to determine the best timing, “dosage” and type of moxibustion are needed as there is no consensus as of yet on the best regimen (7). Comparative effectiveness research looking at topics such as moxibustion’s effects at varying gestational ages and parities (1st baby, 2nd or subsequent) as well research that compares varying “dosages” (how many minutes per day, how often and for how many days) would greatly improve confidence in clinical recommendations.

While many trials examine moxibustion alone, few investigate the outcomes when moxibustion for breech presentation is combined with acupuncture. The small number of trials that have been done find that moxibustion treatment may be more effective when combined with acupuncture. The RCOG Green Top Guidelines (10) reflect this finding with their guideline that moxibustion treatment for breech may further reduce the need for cesarean section when combined with acupuncture. In the Delphi study conducted by Smith and Betts (5) 50% of acupuncturists reported use of acupuncture alongside moxibustion as an important part of treatment for breech presentation, suggesting that the inclusion of acupuncture in future trials would better reflect what is actually occurring in the clinical setting among acupuncturists.

Additionally, comparing the type of moxibustion used would help determine if different forms of moxa make a difference either in effectiveness or compliance. Higashihara et al. (14) compared smokeless moxa, smoke moxa and control groups. They found higher rates of cephalic presentation at the end of the intervention in the smokeless moxibustion group but no differences at birth. Although this was a small, non-randomized pilot study it is a starting point for further research.

There is growing consensus in the research community that pragmatic and comparative effectiveness research is more applicable to real-life settings. This is in part because over and over, “sham” or “placebo” acupuncture (of all sorts) has not been found to be truly inert, therefore acupuncture research that aims to demonstrate efficacy (versus effectiveness) is generally not possible. According to Langevin et al., “Sham acupuncture treatments have consistently been shown to have greater therapeutic effects than conventional placebos (15). For more information on this topic, please see the “Special Acupuncture Research Considerations” page on this site.

Resource Links

Maternity Acupuncture Mentoring and Peer Support (MAMPS) provides high quality post-graduate education and support to acupuncturists who wish to provide care in pregnancy, birth and postpartum. Visit https://www.mamps.org/ for further information on postgraduate training as well as practitioner safety guidelines for the treatment of breech presentation.

The Obstetrical Acupuncture Association (OBAA) provides a resource for both pregnant people and their care providers to find acupuncturists in their area who demonstrate an elevated standard of care and safety within the field of perinatal care. They can be found at https://ob-acupuncture.com/

Spinning Babies: a resource on various modalities and postural exercises for turning malpositioned babies

The Miles Circuit: a set of postural exercises for rotating the baby into an ideal position for birth

Sources

Dekker, Rebecca. “Evidence On: Breech Version.” Evidence Based Birth®, 29 Mar. 2021, evidencebasedbirth.com/what-is-the-evidence-for-using-an-external-cephalic-version-to-turn-a-breech-baby/
Hofmeyr GJ, Kulier R, West HM. External cephalic version for breech presentation at term. Cochrane Database of Systematic Reviews 2015, Issue 4. Art. No.: CD000083. DOI: 10.1002/14651858.CD000083.pub3. Accessed 22 May 2022.
I. van den Berg, G. Kaandorp, J. Bosch, J. Duvekot, L. Arends, M. Hunink, Cost-effectiveness of Breech Version by Acumoxa for women with a breech fetus at 33 weeks gestation: A modeling approach, European Journal of Integrative Medicine, Volume 1, Issue 4, 2009, Page 257, ISSN 1876-3820, https://doi.org/10.1016/j.eujim.2009.08.068

Morris, Sara, et al. “Women’s Experiences of Breech Birth Decision Making: An Integrated Review.” European Journal of Midwifery, vol. 6, no. January, 25 Jan. 2022, pp. 1–14, 10.18332/ejm/143875.
Smith CA, Betts D. The practice of acupuncture and moxibustion to promote cephalic version for women with a breech presentation: implications for clinical practice and research. Complement Ther Med. 2014 Feb;22(1):75-80. doi: 10.1016/j.ctim.2013.12.005. Epub 2013 Dec 12. PMID: 24559820.
Mitchell M, Allen K. An exploratory study of women's experiences and key stakeholders views of moxibustion for cephalic version in breech presentation. Complement Ther Clin Pract. 2008 Nov;14(4):264-72. doi: 10.1016/j.ctcp.2008.05.002. Epub 2008 Jul 22. PMID: 18940713.
Coyle ME, Smith CA, Peat B. Cephalic version by moxibustion for breech presentation. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD003928. DOI: 10.1002/14651858.CD003928.pub3
Liao JA, Shao SC, Chang CT, Chai PY, Owang KL, Huang TH, Yang CH, Lee TJ, Chen YC. Correction of Breech Presentation with Moxibustion and Acupuncture: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2021 May 22;9(6):619. doi: 10.3390/healthcare9060619. PMID: 34067379; PMCID: PMC8224784.
Vas J, Aranda-Regules JM, Modesto M, Ramos-Monserrat M, Barón M, Aguilar I, Benítez-Parejo N, Ramírez-Carmona C, Rivas-Ruiz F. Using moxibustion in primary healthcare to correct non-vertex presentation: a multicentre randomised controlled trial. Acupunct Med. 2013 Mar;31(1):31-8. doi: 10.1136/acupmed-2012-010261. Epub 2012 Dec 18. PMID: 23249535.
Impey LWM, Murphy DJ, Griffiths M, Penna LK on behalf of the Royal College of Obstetricians and Gynaecologists. External Cephalic Version and Reducing the Incidence of Term Breech Presentation. BJOG 2017; 124:e178–e192.
Cardini F, Weixin H. Moxibustion for correction of breech presentation: a randomized controlled trial. JAMA. 1998 Nov 11;280(18):1580-4. doi: 10.1001/jama.280.18.1580. PMID: 9820259.
Cardini F, Lombardo P, Regalia AL, Regaldo G, Zanini A, Negri MG, Panepuccia L, Todros T. A randomised controlled trial of moxibustion for breech presentation. BJOG. 2005 Jun;112(6):743-7. doi: 10.1111/j.1471-0528.2005.00634.x. PMID: 15924530.
Guittier MJ, Pichon M, Dong H, Irion O, Boulvain M. Moxibustion for breech version: a randomized controlled trial. Obstet Gynecol. 2009 Nov;114(5):1034-1040. doi: 10.1097/AOG.0b013e3181bc707a. PMID: 20168104.
Higashihara A, Horiuchi S. Smoke or smokeless moxibustion treatment for breech presentation: A three-arm pilot trial. Jpn J Nurs Sci. 2021 Oct;18(4):e12426. doi: 10.1111/jjns.12426. Epub 2021 May 17. PMID: 33999503; PMCID: PMC8518843
Helene M. Langevin, Peter M. Wayne, Hugh MacPherson, Rosa Schnyer, Ryan M. Milley, Vitaly Napadow, Lixing Lao, Jongbae Park, Richard E. Harris, Misha Cohen, Karen J. Sherman, Aviad Haramati, Richard Hammerschlag, "Paradoxes in Acupuncture Research: Strategies for Moving Forward", Evidence-Based Complementary and Alternative Medicine, vol. 2011, Article ID 180805, 11 pages, 2011. https://doi.org/10.1155/2011/180805
Hopper Koppelman.. Acupuncture: An Overview of Scientific Evidence. Evidence Based Acupuncture. 2018. https://www.evidencebasedacupuncture.org/acupuncture-scientific-evidence/

Can Acupuncture or Moxibustion (Moxa) Help with Turning a Breech Baby?

This article was co-authored by Sarah Tewhey, L.Ac., acupuncturist, herbalist and doula

Why Do We Need to Explore Other Ways of Correcting Breech Presentation?

How Might Acupuncture and/or Moxibustion (Moxa) be Used?

What does the Research Show?

Does It Really Matter Which Acupuncture Point Gets Moxibustion?

Moxibustion Included in Clinical Guidelines

Risk Factors and Contraindications

Finding a Trained Practitioner

Resource Links

Sources

Health Topics

Lower back pain or pelvic pain

Nausea/Vomiting and Hyperemesis Gravidarum

Prebirth and Labor Induction

Pain Management in Labor

Safety of Acupuncture During Pregnancy

Anxiety and Depression

Threatened Miscarriage

Pre-Eclampsia

Insomnia